See All

Preferences

My Communities

My Discussions

My Email Digests

I was recently prescribed Niaspan by my cardiologist because the drug Crestor I've recently been taking worked so well in lowering my cholesterol that it also caused a drop in my HDL ( good cholesterol ) too.

According to my cardiologist, elevating my HDL will help lower my risk of having a heart attack, the problem is, I didn't tolerate Niaspan well.

I'm wondering if there are other alternatives to Niaspan, since I only took the medication for one week before being advised to stop, are there potential risks involved if I start taking a Niaspan alternative ? I was told about a possible side effect that can cause irreparable liver damage by going from Niaspan to another Niacin supplement, but I don't recall the details now ?

Thanks for your Reply!

9 Replies |Watch This Discussion | Report This| Share this:Niaspan alternatives ?I was recently prescribed Niaspan by my cardiologist because the drug Crestor I've recently been taking worked so well in lowering my cholesterol that it also caused a drop in my HDL ( good cholesterol ) too.

According to my cardiologist, elevating my HDL will help lower my risk of having a heart attack, the problem is, I didn't tolerate Niaspan well.

I'm wondering if there are other alternatives to Niaspan, since I only took the medication for one week before being advised to stop, are there potential risks involved if I start taking a Niaspan alternative ? I was told about a possible side effect that can cause irreparable liver damage by going from Niaspan to another Niacin supplement, but I don't recall the details now ?

Thanks, I should have been more specific about the reaction I had to Niaspan. I didn't experience flushing, instead I felt muscle weakness unlike anything I've had before. I take a daily teaspoon of cod liver oil which includes Omega 3 fatty acids along with CoQ10, B-complex, multivitamin, Cal-Mag with D, chromium picolinate, chelated copper, malic acid, zinc, low dose aspirin, Caumadin, Crestor, and Lisinopril. I don't consume red meat or pork, I cook with olive oil, grape seed oil or Smart Balance, I either grill, broil or pan sear, seldom have fried foods and I follow the glycemic index food suggestions to help avoid hidden sugars.

Thanks for your Reply!

Report This| Share this:Niaspan alternatives ?Thanks, I should have been more specific about the reaction I had to Niaspan. I didn't experience flushing, instead I felt muscle weakness unlike anything I've had before. I take a daily teaspoon of cod liver oil which includes Omega 3 fatty acids along with CoQ10, B-complex, multivitamin, Cal-Mag with D, chromium picolinate, chelated copper, malic acid, zinc, low dose aspirin, Caumadin, Crestor, and Lisinopril. I don't consume red meat or pork, I cook with olive oil, grape seed oil or Smart Balance, I either grill, broil or pan sear, seldom have fried foods and I follow the glycemic index food suggestions to help avoid hidden sugars.

Increase in exercise and losing weight, if appropriate, are other ways to help increase HDL. Note, if you try losing weight some research that I have seen to indicate that the HDL does not raise until after the weight is lost.

Also, if you are so inclined moderate alcohol raises it. That would be 1-2 drinks for a man or 1 for a woman.

The suggestions for raising HDL are for up to 4 grams of Omega 3.

I looked at the label for one brand of cod liver oil and it indicated that it had one gram. And you probably don't want to take 4 teaspoon of it.

And I found this http://www.wellnessletter.com/ucberkeley/dietary-supplements/cod-liver-oil/#Potential problem: Cod liver oil, bottled or in capsule form, often contains very high levels of A, which can weaken bones and cause birth defects. Just one teaspoon may have 4,500 IU of A, and the standard dose is one to three teaspoons a day. Capsules of cod liver oil contain less oil, but the vitamin can still add up, especially on top of the amount you get from foods and from a multivitamin, if you take one. Studies have found that as little as 6,000 IU of vitamin A daily can interfere with bone growth and promote fractures. And women of childbearing age should not exceed 10,000 IU of vitamin A because of the risk of birth defects. So make sure the label says that the vitamin A content has been reduced. Fish oil supplements, and fish itself, do not have much vitamin A, which is concentrated in the liver (in beef and chicken liver as well).

And I see that you are taking a calcium suppliment, probably for bone health.

But there have been several studies that indicate that calcium supplements can increase the chance of heart attacks. The last one was just came out.

People who take calcium supplements could be increasing their risk of having a heart attack, according to researchers in Germany.

There have been a compare diets of people with and without a condition which imply that they are lacking a certain vitamin or mineral in their diet.

But also most everytime when there have been blind clinic trails using a supplement to counter that lack that there is no improvement and in some some case it is worse.

And based on this many doctors don't recommend any kind of supplement or vit or mineral unless you have been tested and shown to lacking in a specific area.

And that a balanced diet that has the needed mix is better than adding suppliments.

Now I am not a medical professional, nor do I know anything about your medical history.

And I know that everything affects the warfarin, including the cod liver oil/fish oil, and any greens that you increase to increase calcuim intake.

But if it was me I would take with my doctor about discontinuing all the supplements except high levels of fish oil (or cod liver oil if it does not have high levels of vit A), vit D (athought you might want to have you levels checked) and possibly the CO Q-10 (the studies on that have been limited and mixed).

BTW, I did not discontinue calcium supplement, that my PCP prescribed several years ago, after discussing the studies that came out about 1-2 years ago with my cardiologist and current PCP.

But I am a male and have strong bones.

Thanks for your Reply!

Report This| Share this:Niaspan alternatives ?Increase in exercise and losing weight, if appropriate, are other ways to help increase HDL. Note, if you try losing weight some research that I have seen to indicate that the HDL does not raise until after the weight is lost.

Also, if you are so inclined moderate alcohol raises it. That would be 1-2 drinks for a man or 1 for a woman.

The suggestions for raising HDL are for up to 4 grams of Omega 3.

I looked at the label for one brand of cod liver oil and it indicated that it had one gram. And you probably don't want to take 4 teaspoon of it.

And I found this http://www.wellnessletter.com/ucberkeley/dietary-supplements/cod-liver-oil/#Potential problem: Cod liver oil, bottled or in capsule form, often contains very high levels of A, which can weaken bones and cause birth defects. Just one teaspoon may have 4,500 IU of A, and the standard dose is one to three teaspoons a day. Capsules of cod liver oil contain less oil, but the vitamin can still add up, especially on top of the amount you get from foods and from a multivitamin, if you take one. Studies have found that as little as 6,000 IU of vitamin A daily can interfere with bone growth and promote fractures. And women of childbearing age should not exceed 10,000 IU of vitamin A because of the risk of birth defects. So make sure the label says that the vitamin A content has been reduced. Fish oil supplements, and fish itself, do not have much vitamin A, which is concentrated in the liver (in beef and chicken liver as well).

And I see that you are taking a calcium suppliment, probably for bone health.

But there have been several studies that indicate that calcium supplements can increase the chance of heart attacks. The last one was just came out.

People who take calcium supplements could be increasing their risk of having a heart attack, according to researchers in Germany.

There have been a compare diets of people with and without a condition which imply that they are lacking a certain vitamin or mineral in their diet.

But also most everytime when there have been blind clinic trails using a supplement to counter that lack that there is no improvement and in some some case it is worse.

And based on this many doctors don't recommend any kind of supplement or vit or mineral unless you have been tested and shown to lacking in a specific area.

And that a balanced diet that has the needed mix is better than adding suppliments.

Now I am not a medical professional, nor do I know anything about your medical history.

And I know that everything affects the warfarin, including the cod liver oil/fish oil, and any greens that you increase to increase calcuim intake.

But if it was me I would take with my doctor about discontinuing all the supplements except high levels of fish oil (or cod liver oil if it does not have high levels of vit A), vit D (athought you might want to have you levels checked) and possibly the CO Q-10 (the studies on that have been limited and mixed).

BTW, I did not discontinue calcium supplement, that my PCP prescribed several years ago, after discussing the studies that came out about 1-2 years ago with my cardiologist and current PCP.

I take Cal-Mag because of the malic acid I also take, I was diagnosed with fibromyalgia years ago and the malic acid along with Cal-Mag helps with symptoms. I gave my cardiologist the list of supplements I'm taking and he's OK with my regimen. I ride my stationary bike and use weights, I also ride my bicycle and take walks for exercise. I had a period where I wasn't able to exercise due to back problems, I believe getting back into an exercise routine will make all the difference.

I take Cal-Mag because of the malic acid I also take, I was diagnosed with fibromyalgia years ago and the malic acid along with Cal-Mag helps with symptoms. I gave my cardiologist the list of supplements I'm taking and he's OK with my regimen. I ride my stationary bike and use weights, I also ride my bicycle and take walks for exercise. I had a period where I wasn't able to exercise due to back problems, I believe getting back into an exercise routine will make all the difference.

Niaspan is an extended release nicotinic acid (niacin). there are many non-prescription forms of niacin, but they don't necessarily indicate nicotinic acid vs niacinamide (the metabolite of nicotinic acid most commonly used in vitamin supplements) vs inositol hexanicotinate (no-flush niacin). In addition, dissolution times are generally not known for the nicotinic acid preparations.

However, there is dissolution data by Poon et al, from the Am J Health-Syst Pharm that identify one over-the-counter preparation as having the same dissolution profile to Niaspan, and it is the wax-matrix niacin called Endur-acin. It also has published safety and efficacy studies.

Thanks for your Reply!

Report This| Share this:Niaspan alternatives ?Niaspan is an extended release nicotinic acid (niacin). there are many non-prescription forms of niacin, but they don't necessarily indicate nicotinic acid vs niacinamide (the metabolite of nicotinic acid most commonly used in vitamin supplements) vs inositol hexanicotinate (no-flush niacin). In addition, dissolution times are generally not known for the nicotinic acid preparations.

However, there is dissolution data by Poon et al, from the Am J Health-Syst Pharm that identify one over-the-counter preparation as having the same dissolution profile to Niaspan, and it is the wax-matrix niacin called Endur-acin. It also has published safety and efficacy studies.

Related Drug Reviews

Report Problems With Your Medications to the FDA

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

The opinions expressed in WebMD Communities are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. Communities are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.

Do not consider Communities as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.